Eczema Flashcards
What is eczema?
A group of skin conditions that cause inflammation/ irritation of the skin - itchy
also known as dermatitis
Clinical features of eczema?
Erythema
Itch
Scaling
Dryness
Acute
- pain
- bleeding
- weeping
- vesicles/blisters
Chronic
- fissures
- lichenification
Types of eczema
- atopic
- discoid
- seborrhoeic
- venous/varicose/stasis/gravitational
- asteatotic
- pompholytic
- irritant contact
- allergic contact
Common places for eczema?
flexures
e.g. elbows, behind knees
Epidemiology of atopic eczema
- prevalence in children around 10-20%
- onset usually under 2y
- 50% grow out by 2y
- 80% grow out by adolescence
- asthma, hayfever, eczema - atopy
Aetiology of atopic eczema?
genetic and environmental
cause unclear lol
What is atopic eczema exacerbated by?
- irritants e.g. soap, nylon clothing
- illness/ teething
- skin infection
- stress
- change in weather
- allergy
What age group normally gets seborrhoeic eczema?
Young-middle aged adults
Which organism is seborrhoeic eczema associated with?
Pityrosporum spp
What is seborrhoeic eczema exacerbated by?
alcohol
Treatment of seborrhoeic eczema?
- emollients
- topical antifungals
- mildly potent topical steroidsl
What might discoid eczema be a manifestation of?
atopic eczema
What is varicose eczema a sign of?
chronic venous disease
Why is compression helpful in varicose eczema
To prevent recurrence
What is irritant contact dermatitis?
Direct effect of irritant substances destroying epidermis
Most common site of irritant contact dermatitis?
Dorsum of hands and finger webbs
Irritant contact dermatitis is common in which occupations?
hairdressers chefs housewives cleaners nurses
What is allergic contact dermatitis?
Eczema following a type 4 delayed cell mediated allergic reaction to contact with a substance
Common sources causing allergic contact dermatitis?
- nickel in jewellery and buckles
- hair dye
- plants
- topical medications
- fragrance
- occupational
How is allergic contact dermatitis diagnosed?
Patch testing
- series of substances placed on metal plate on patient’s back for 48h and skin is measured at 48h and 72h for a reaction
Management of eczema?
- Avoid exacerbating factors
- Treat dry skin with emollient
- Treat active eczema with topical steroids
- Consider 2nd line treatments if ineffective or side effects
Example of mild steroid?
Hydrocortisone 1%
- face
- children
Example of a moderate steroid?
Eumovate (clobetosome)
- face and body
- children and adults
Example of a potent steroid?
Betnovate, Elocon
- do not use on face/ special sites
- adults
